Basic Information
| Provider Information | |||||||||
| NPI: | 1043262595 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAMASWAMY | ||||||||
| FirstName: | VANDANA | ||||||||
| MiddleName: | |||||||||
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| Credential: | CPNP | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | RAMASWAMY | ||||||||
| OtherFirstName: | DONNA | ||||||||
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| OtherCredential: | CPNP | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2810 ARBOR SPRINGS TRACE | ||||||||
| Address2: | |||||||||
| City: | TUCKER | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30084 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7704144142 | ||||||||
| FaxNumber: | 7704144142 | ||||||||
| Practice Location | |||||||||
| Address1: | 1405 CLIFTON RD NE | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4042562593 | ||||||||
| FaxNumber: | 4043219688 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | RN150908 | GA | X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 208G00000X | RN150908 | GA | X | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
No ID Information.